Natural History and Management of Blunt Traumatic Pseudoaneurysms of the Internal Carotid Artery: The Harborview Algorithm Based Off a 10-Year Experience.

Abstract:

OBJECTIVE:To define the natural history of, and treatment strategy for, blunt traumatic internal carotid artery (ICA) pseudoaneurysms. BACKGROUND:The natural history and management of traumatic ICA pseudoaneurysms is controversial. METHODS:We retrospectively identified all traumatic ICA pseudoaneurysms diagnosed on head/neck computed tomographic angiography at a high-volume trauma center over a 10-year period. Radiographic and clinical data were recorded, and a treatment algorithm was derived. RESULTS:Forty-three pseudoaneurysms were diagnosed in 39 patients. All patients were treated with daily aspirin unless contraindicated, and 82% underwent daily transcranial Doppler ultrasonography with embolic monitoring. A rate of 8 or more emboli per hour was predictive of embolic stroke (P = 0.0076). Acute ischemic or embolic stroke was seen in 7 patients (16%) with an overall mortality in this subpopulation of 42% (n = 3). Four patients (9%) underwent acute surgical treatment (parent vessel sacrifice and/or arterial bypass) for ongoing ischemia. Long-term radiographic and clinical follow-up was obtained for 36 surviving patients (mean = 8 months; range: 1 week-5 years), all of whom were maintained on daily aspirin. No delayed ischemic or embolic events were reported. For ICA pseudoaneurysms treated with aspirin and observation alone, 9 (28%) increased in size, 17 (53%) decreased or stabilized, and 6 (19%) resolved. Enlargement of 5 mm or more in maximal diameter underwent delayed endovascular treatment with a 100% obliteration rate and no complications. CONCLUSIONS:Traumatic ICA pseudoaneurysms are safely treated with daily aspirin, embolic monitoring, and radiographic surveillance. Acute stroke or hemorrhage, or delayed radiographic progression, are indications for endovascular or surgical treatment.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Morton RP,Levitt MR,Emerson S,Ghodke BV,Hallam DK,Sekhar LN,Kim LJ,Chesnut RM

doi

10.1097/SLA.0000000000001158

subject

Has Abstract

pub_date

2016-04-01 00:00:00

pages

821-6

issue

4

eissn

0003-4932

issn

1528-1140

journal_volume

263

pub_type

杂志文章
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    doi:10.1097/00000658-198904000-00009

    authors: Nelken N,Lewis F

    更新日期:1989-04-01 00:00:00

  • Multicenter Stratified Comparison of Hospital Costs Between Laparoscopic and Open Colorectal Cancer Resections: Influence of Tumor Location and Operative Risk.

    abstract:OBJECTIVE:To compare actual 90-day hospital costs between elective open and laparoscopic colon and rectal cancer resection in a daily practice multicenter setting stratified for operative risk. BACKGROUND:Laparoscopic resection has developed as a commonly accepted surgical procedure for colorectal cancer. There are co...

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    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000002000

    authors: Govaert JA,Fiocco M,van Dijk WA,Kolfschoten NE,Prins HA,Dekker JWT,Tollenaar RAEM,Tanis PJ,Wouters MWJM,Dutch Value Based Healthcare Study Group.

    更新日期:2017-12-01 00:00:00

  • Artesunate Protects Against the Organ Injury and Dysfunction Induced by Severe Hemorrhage and Resuscitation.

    abstract:OBJECTIVE:To evaluate the effects of artesunate on organ injury and dysfunction associated with hemorrhagic shock (HS) in the rat. BACKGROUND:HS is still a common cause of death in severely injured patients and is characterized by impairment of organ perfusion, systemic inflammatory response, and multiple organ failur...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001664

    authors: Sordi R,Nandra KK,Chiazza F,Johnson FL,Cabrera CP,Torrance HD,Yamada N,Patel NS,Barnes MR,Brohi K,Collino M,Thiemermann C

    更新日期:2017-02-01 00:00:00

  • Thromboembolism after trauma: an analysis of 1602 episodes from the American College of Surgeons National Trauma Data Bank.

    abstract:OBJECTIVE:Venous thromboembolic events (VTE) are potentially preventable causes of morbidity and mortality after injury. We hypothesized that the current clinical incidence of VTE is relatively low and that VTE risk factors could be identified. METHODS:We queried the ACS National Trauma Data Bank for episodes of deep ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000137138.40116.6c

    authors: Knudson MM,Ikossi DG,Khaw L,Morabito D,Speetzen LS

    更新日期:2004-09-01 00:00:00

  • A novel therapeutic strategy for attenuating neutrophil-mediated lung injury in vivo.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200202000-00018

    authors: Sookhai S,Wang JJ,McCourt M,Kirwan W,Bouchier-Hayes D,Redmond P

    更新日期:2002-02-01 00:00:00

  • Is carcinoma of the gallbladder a curable lesion?

    abstract::Carcinoma of the gallbladder is an uncommon, but not rare tumor that is associated with a 5% five-year survival rate after resection and this rate has not appreciably improved over the last decades in most series. Nevin et al.(20) however have reported that favorably staged gallbladder cancers (according to histologic...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198205000-00012

    authors: Wanebo HJ,Castle WN,Fechner RE

    更新日期:1982-05-01 00:00:00

  • Incidence and consequence of an hepatic artery injury in patients with postcholecystectomy bile duct strictures.

    abstract:OBJECTIVE:To compare the clinical presentation and results of treatment of postcholecystectomy bile duct injuries in patients with and without arterial injuries. SUMMARY BACKGROUND DATA:Incidence and impact of arterial injuries in patients with a postcholecystectomy biliary injury are unknown, although they are claime...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000074983.39297.c5

    authors: Alves A,Farges O,Nicolet J,Watrin T,Sauvanet A,Belghiti J

    更新日期:2003-07-01 00:00:00

  • Pouch Versus No Pouch Following Total Gastrectomy: Meta-analysis of Randomized and Non-randomized Studies.

    abstract:OBJECTIVE:The aim of the study was to assess the impact of pouch reconstruction on perioperative outcomes, postprandial symptoms, nutritional and anthropometric parameters, and overall quality of life after total gastrectomy for gastric malignancy. SUMMARY BACKGROUND DATA:The short-term perioperative risks and longer ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,meta分析

    doi:10.1097/SLA.0000000000003082

    authors: Syn NL,Wee I,Shabbir A,Kim G,So JB

    更新日期:2019-06-01 00:00:00

  • Gastrointestinal myoelectric and clinical patterns of recovery after laparotomy.

    abstract::The objective of this study was to define the patterns of myoelectric activity that occur throughout the gastrointestinal tract during normal recovery from laparotomy. Electrodes were placed on the stomach, jejunum, and transverse colon of 44 patients undergoing laparotomy. Basal electric rhythms in all areas showed n...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199006000-00018

    authors: Waldhausen JH,Shaffrey ME,Skenderis BS 2nd,Jones RS,Schirmer BD

    更新日期:1990-06-01 00:00:00

  • Aggressive resection of metastatic disease in selected patients with malignant gastrinoma.

    abstract::Fifteen patients with Zollinger-Ellison syndrome followed at the National Institutes of Health with extensive metastatic disease had an actuarial 5-year survival of 20%. Therefore, in 1982 a prospective study to examine the effect and feasibility of removing all gross tumor in selected patients with extensive metastat...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198604000-00003

    authors: Norton JA,Sugarbaker PH,Doppman JL,Wesley RA,Maton PN,Gardner JD,Jensen RT

    更新日期:1986-04-01 00:00:00

  • The Global Incidence of Appendicitis: A Systematic Review of Population-based Studies.

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    journal_title:Annals of surgery

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/SLA.0000000000002188

    authors: Ferris M,Quan S,Kaplan BS,Molodecky N,Ball CG,Chernoff GW,Bhala N,Ghosh S,Dixon E,Ng S,Kaplan GG

    更新日期:2017-08-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/SLA.0b013e31821fd1ce

    authors: Vlug MS,Wind J,Hollmann MW,Ubbink DT,Cense HA,Engel AF,Gerhards MF,van Wagensveld BA,van der Zaag ES,van Geloven AA,Sprangers MA,Cuesta MA,Bemelman WA,LAFA study group.

    更新日期:2011-12-01 00:00:00

  • Oxygen as an isolated variable influences resistance to infection.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198812000-00018

    authors: Jönsson K,Hunt TK,Mathes SJ

    更新日期:1988-12-01 00:00:00

  • Hilar cholangiocarcinoma: current management.

    abstract:OBJECTIVE:To review the literature with regard to outcome of surgical management for hilar cholangiocarcinoma (Klatskin tumor). BACKGROUND:Hilar cholangiocarcinoma is a rare tumor with a poor prognosis. Surgical resection provides the only possibility for cure. Advances in hepatobiliary imaging and surgical strategies...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/SLA.0b013e3181afe0ab

    authors: Ito F,Cho CS,Rikkers LF,Weber SM

    更新日期:2009-08-01 00:00:00

  • Noncirrhotic portal vein thrombosis. Physiology before and after shunts.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198009000-00009

    authors: Warren WD,Millikan WJ Jr,Smith RB 3rd,Rypins EB,Henderson JM,Salam AA,Hersh T,Galambos JT,Faraj BA

    更新日期:1980-09-01 00:00:00

  • Effect of lymphatic mapping on diagnosis and treatment of patients with T1a, T1b favorable breast cancer.

    abstract:OBJECTIVE:To investigate the incidence of nodal metastasis in a consecutive series of patients treated at the authors' institution with highly selective criteria, and to determine the impact that lymphatic mapping and sentinel node biopsy have on the detection of nodal metastases in this carefully selected patient popu...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.SLA.0000071564.27229.A9

    authors: Jakub JW,Ebert MD,Diaz NM,Cantor A,Reintgen DS,Dupont EL,Shons AR,Cox CE

    更新日期:2003-06-01 00:00:00

  • Isolated limb perfusion with tumor necrosis factor and melphalan for limb salvage in 186 patients with locally advanced soft tissue extremity sarcomas. The cumulative multicenter European experience.

    abstract:OBJECTIVE:The objective of the study was to achieve limb salvage in patients with locally advanced soft tissue sarcomas that can only be treated by amputation or functionally mutilating surgery by performing an isolated limb perfusion (ILP) with tumor necrosis factor (TNF) + melphalan (M) as induction biochemotherapy t...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1097/00000658-199612000-00011

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    更新日期:1996-12-01 00:00:00

  • Fontan operation in the current era: a 15-year single institution experience.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181858286

    authors: Hirsch JC,Goldberg C,Bove EL,Salehian S,Lee T,Ohye RG,Devaney EJ

    更新日期:2008-09-01 00:00:00

  • Critical operative management of small bowel obstruction.

    abstract::The records of 238 patients with the diagnosis of small bowel obstruction at the University of Illinois Hospital from 1967 through the spring of 1976 were reviewed. Mortality, intra-operative management, and clinical findings were evaluated. Previous reports list a mortality of gangrenous small bowel obstruction, seco...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197802000-00017

    authors: Stewardson RH,Bombeck CT,Nyhus LM

    更新日期:1978-02-01 00:00:00

  • Influence of total parenteral nutrition on tissue lipoprotein lipase activity during chronic and acute illness.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198112000-00003

    authors: Robin AP,Greenwood MR,Askanazi J,Elwyn DH,Kinney JM

    更新日期:1981-12-01 00:00:00

  • Readmission after colectomy for cancer predicts one-year mortality.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181d3d27c

    authors: Greenblatt DY,Weber SM,O'Connor ES,LoConte NK,Liou JI,Smith MA

    更新日期:2010-04-01 00:00:00

  • Abdominal aneurysm and horseshoe kidney: a review.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197503000-00015

    authors: Bietz DS,Merendino KA

    更新日期:1975-03-01 00:00:00

  • Increased CD4+ CD25+ T regulatory cell activity in trauma patients depresses protective Th1 immunity.

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    pub_type: 杂志文章

    doi:10.1097/01.sla.0000239031.06906.1f

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    更新日期:2006-10-01 00:00:00

  • Adrenalectomy for Secondary Malignancy: Patients, Outcomes, and Indications.

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    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003876

    authors: Wachtel H,Roses RE,Kuo LE,Lindeman BM,Nehs MA,Tavakkoli A,Parangi S,Hodin RA,Fraker DL,James BC,Carr AA,Wang TS,Solórzano CC,Lubitz CC

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  • General surgery in patients on maintenance hemodialysis.

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    pub_type: 杂志文章

    doi:10.1097/00000658-197406000-00008

    authors: Haimov M,Glabman S,Schupak E,Neff M,Burrows L

    更新日期:1974-06-01 00:00:00

  • Appendectomy by residents is safe and not associated with a higher incidence of complications: a retrospective cohort study.

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    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318248bdb5

    authors: Graat LJ,Bosma E,Roukema JA,Heisterkamp J

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    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31825429c0

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    更新日期:2012-06-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1097/00000658-197609000-00010

    authors: Paulson DL,Reisch JS

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    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1097/01.sla.0000184210.68646.77

    authors: Posther KE,McCall LM,Blumencranz PW,Burak WE Jr,Beitsch PD,Hansen NM,Morrow M,Wilke LG,Herndon JE 2nd,Hunt KK,Giuliano AE

    更新日期:2005-10-01 00:00:00

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    pub_type: 杂志文章,评审

    doi:10.1097/00000658-199810000-00017

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    更新日期:1998-10-01 00:00:00